"Triglycerides: Why do they matter?

By Mayo Clinic staff.

http://www.mayoclinic.com/health/triglycerides/CL00015

High triglycerides are link to heart disease. 

Triglycerides

Triglycerides are fat or lipid in  blood. 

Food eaten are converted into calories. Unused calories are converted into triglycerides and stored in fat cells for future energy need. These stored triglycerides are released by hormones as needed energy between meals. When more calories (food) are eaten than needed, specially carbohydrates and fats, one may develop high blood triglycerides (hypertriglyceridemia).

Triglyceride levels:

Normal — Less than 150 milligrams per deciliter (mg/dL), or less than 1.7 millimoles per L (mmol/L)

Borderline high — 150 to 199 mg/dL (1.8 to 2.2 mmol/L)

High — 200 to 499 mg/dL (2.3 to 5.6 mmol/L)

Very high — 500 mg/dL or above (5.7 mmol/L or above)

100 mg/dL (1.3 mmol/L) or lower achieved by lifestyle modification such as diet, weight loss and physical activity.

Triglycerides and cholesterol

2.Stored unused calories..............Used to build cells and certain hormones.

used as future body energy

High triglycerides

High triglycerides are link to hardening of the arteries (atherosclerosis) leading to obesity, too much fat around the waist, metabolic syndrome, high blood pressure/triglycerides/blood sugar, abnormal cholesterol levels, type 2 diabetes, low levels of thyroid hormones (hypothyroidism), liver or kidney disease, or rare genetic conditions that affect how body converts fat to energy, effect of medications such as beta blockers, birth control pills, diuretics, steroids and tamoxifen.

Lowering triglycerides

Lifestyle modification:

a) Eat plant base and low saturated fat diet which usually takes care of b, c, and d.

b) Lose weight: Even losing 5 to 10 pounds can help lower triglycerides.

c) Calories reduction. Eat complex carbohydrate from vegetables, avoid sugar from all sources which can increase triglycerides levels

d) Reduce cholesterol: Meats, egg yolks and whole milk products, high in saturated fat.

e) Eat plant based monounsaturated fat found in plants: olive, peanut and canola oils. Avoid saturated and trans fat.

f) Omega-3 fatty acids: Sources are mackerel, salmon, sardines and supplements.

g) Limit alcohol which are high in calories and even small amount can raise triglyceride levels.

h) Exercise  at least 30 minutes of physical activity 5-7 days/week.

i) Control diabetes and high blood pressure.

Medications

When lifestyle  modifications do noy work.

a) Niacin (Niaspan)

b) Fibrates (fenofibrate (Lofibra, TriCor) and gemfibrozil (Lopid).

c) Pantothenic acid

http://lpi.oregonstate.edu/infocenter/vitamins/pa/

High cholesterol

A pantothenic acid derivative called pantethine has been reported by a number of investigators to have a cholesterol-lowering effect. Pantethine is actually two molecules of pantetheine joined by a disulfide bond (chemical bond between two molecules of sulfur). In the synthetic pathway of coenzyme A (CoA), pantethine is closer to CoA than pantothenic acid and is the functional component of CoA and acyl carrier proteins. Several studies found doses of 900 mg of pantethine daily (300 mg three times daily) to be significantly more effective than placebo in lowering total cholesterol and triglyceride levels in the blood of both diabetic and non-diabetic individuals (11). Pantethine was also found to lower cholesterol and triglyceride levels in diabetic patients on hemodialysis without adverse side effects. The fact that pantethine has few side effects was especially attractive for hemodialysis patients because of the increased risk of drug toxicity in patients with renal (kidney) failure (12). Pantethine is not a vitamin; it is a derivative of pantothenic acid. The decision to use pantethine to treat elevated blood cholesterol or triglycerides should be made in collaboration with a qualified health care provider who can provide appropriate follow-up.

Sources

Food sources

Pantothenic acid is available in a variety of foods. Rich sources of pantothenic acid include liver and kidney, yeast, egg yolk, and broccoli. Fish, shellfish, chicken, milk, yogurt, legumes, mushrooms, avocado, and sweet potatoes are also good sources. Whole grains are good sources of pantothenic acid, but processing and refining grains may result in a 35% to 75% loss. Freezing and canning of foods result in similar losses (8). Large national, nutritional surveys were unable to estimate pantothenic acid intake due to the scarcity of data on the pantothenic acid content of food. Smaller studies estimate average daily intakes of pantothenic acid to be from 5 to 6 mg/day in adults. The table below lists some rich sources of pantothenic acid along with their content in milligrams (mg). For more information on the nutrient content of foods, search the USDA food composition database.

Intestinal bacteria

The bacteria that normally colonize the colon (large intestine) are capable of making their own pantothenic acid. It is not yet known whether humans can absorb the pantothenic acid synthesized by their own intestinal bacteria in meaningful amounts. However, a specialized process for the uptake of biotin and pantothenic acid was identified in cultured cells derived from the lining of the colon, suggesting that humans may be able to absorb pantothenic acid and biotin produced by intestinal bacteria (13). 

Supplements

Pantothenic acid

Supplements commonly contain pantothenol, a more stable alcohol derivative, which is rapidly converted to pantothenic acid by humans. Calcium and sodium D-pantothenate, the calcium and sodium salts of pantothenic acid, are also available as supplements (4).

d) Statins.

If you're worried about your cholesterol and have already started exercising and eating healthier foods, you might wonder if adding a cholesterol-lowering supplement to your diet can help reduce your numbers. Although few natural products have been proven to reduce cholesterol, some might be helpful. With your doctor's OK, consider these cholesterol-lowering supplements and products.

Another popular cholesterol-lowering supplement is red yeast rice. There is some evidence that red yeast rice can help lower your LDL cholesterol. However, the Food and Drug Administration has warned that red yeast rice products could contain a naturally occurring form of the prescription medication known as lovastatin. Lovastatin in the red yeast rice products in question is potentially dangerous because there's no way for you to know what level or quality of lovastatin might be in red yeast rice.

Sometimes healthy lifestyle choices, including supplements and other cholesterol-lowering products, aren't enough. If your doctor prescribes medication to reduce your cholesterol, take it as directed while you continue to focus on a healthy lifestyle. As always, if you decide to take an herbal supplement, be sure to tell your doctor. The herbal s

Herbal supplements may not mix with heart medicines

Some herbal supplements can have dangerous interactions with heart medications.

Herbal supplements are natural, so they must be safe, right? Not necessarily. Herbal supplements can have strong effects in the body, and some can interact with prescription medications used to treat heart and circulatory problems, such as high blood pressure and heart failure. Some of these interactions can even be dangerous.

Herbal supplements and prescription medications

At least a quarter of adults who take prescription medications also take dietary supplements, including herbal supplements. That number is even higher among adults older than age 70 — three-quarters report using both prescription medications and dietary supplements.

Yet many herbal supplements interact with medications for cardiovascular disease — which are widely prescribed for older adults. The chances of herbs and drugs interacting are high. Indeed, 8 of the 10 most widely used supplements interact with the blood-thinning medication warfarin (Coumadin). Here are just a few of the herbal supplements that can affect warfarin:

• Danshen
• Dong quai
• Evening primrose oil
• Garlic
• Ginkgo
• Ginseng
• St. John's wort

That's why it's so important to talk with your doctor before taking herbal supplements if you take prescription medications. Your doctor and pharmacist can help you avoid risky interactions.upplement you take may interact with other medications you take."

Herbal supplements and drug interactions

This table shows popular herbal supplements and interactions with common heart medications. It's not a complete list, however, so be sure to discuss with your doctor the medications and supplements you take.

Playing it safe with herbal supplements

If your doctor tells you it's OK to use an herbal supplement combined with a medication, make sure you follow dosing instructions carefully. Watch for any unusual signs or symptoms that you could be having a drug interaction, such as rapid heartbeat, low blood sugar or changes in blood pressure.

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"Red yeast rice (Monascus purpureus)

• http://www.mayoclinic.com/health/red-yeast-rice/NS_patient-redyeast

Red yeast rice (Monascus purpureus)

Background

Red yeast rice is the product of yeast ( Monascuspurpureus ) grown on rice, and is served as a dietary staple in some Asian countries. It contains several compounds collectively known as monacolins, substances known to inhibit cholesterol synthesis. One of these, "monacolin K," is a potent inhibitor of HMG-CoA reductase, and is also known as mevinolin or lovastatin (Mevacor®, a drug produced by Merck & Co., Inc).

Red yeast rice extract has been sold as a natural cholesterol-lowering agent in over the counter supplements, such as Cholestin ^TM (Pharmanex, Inc). However, there has been legal and industrial dispute as to whether red yeast rice is a drug or a dietary supplement, involving the manufacturer, the U.S. Food and Drug Administration (FDA), and the pharmaceutical industry (particularly producers of HMG-CoA reductase inhibitor prescription drugs or "statins").

The use of red yeast rice in China was first documented in the Tang Dynasty in 800 A.D. A detailed description of its manufacture is found in the ancient Chinese pharmacopoeia, Ben Cao Gang Mu-Dan Shi Bu Yi, published during the Ming Dynasty (1368-1644). In this text, red yeast rice is proposed to be a mild aid for gastric problems (indigestion, diarrhea), blood circulation, and spleen and stomach health. Red yeast rice in a dried, powdered form is called Zhi Tai. When extracted with alcohol it is called Xue Zhi Kang."